血液透析患者透析内血压变化的特征和影响因素:一项回顾性研究

IF 2.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL International Journal of General Medicine Pub Date : 2024-10-18 eCollection Date: 2024-01-01 DOI:10.2147/IJGM.S479035
Haifan Xu, Xiaoshuang Wang, Miao Feng, Liqun Chen
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引用次数: 0

摘要

目的研究背景因素与血压变异性(BPV)之间的相关性,以及血液透析(HD)患者透析期间血压变异性指标对心血管死亡和全因死亡率的预后价值:对 264 名血液透析患者进行了为期 36 个月的回顾性研究。每位患者 3 个月内的透析血压用于计算 BPV 指标,包括标准差 (SD)、变异系数 (CV)、平均实际变异性 (ARV)、血压变化 (ΔBP)、血压变化百分比 (ΔBP/前 BP)。主要结果是心血管疾病死亡和全因死亡率:结果:年龄、体重指数(BMI)、透析前血压、透析间期体重增加率(IDWG%)、α-受体阻滞剂和胆固醇水平与透析中血压变化呈正相关。血红蛋白和白蛋白与缓解期 BPV 呈负相关。在 Cox 回归分析中,SBP-ARV、ΔSBP 和 ΔSBP/pre-SBP 是心血管疾病死亡的独立危险因素(HR:1.087,95% CI:1.001-1.181,p = 0.047;HR:1.072,95% CI:1.016-1.131,p = 0.011;HR:1.107,95% CI:1.011-1.211,p = 0.028)。在预测全因死亡方面,SBP-ARV 的 AUC 最大,为 0.593(p = 0.022)。SBP-ARV、ΔSBP和ΔSBP/pre-SBP在预测心血管疾病死亡方面显示出相对较大的区域(AUC分别为0.631、0.639和0.620;p分别为0.007、0.004和0.013):结论:年龄、体重指数、IDWG%、透析前血压、白蛋白、血红蛋白、α-受体阻滞剂和总胆固醇与透析中血压变异显著相关。SBP-ARV、ΔSBP和ΔSBP/透析前SBP是心血管疾病死亡率的独立危险因素,各种BPV指标的预后价值没有差异。
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Characteristics and Influencing Factors of Intra-Dialysis Blood Pressure Variability in Hemodialysis Patients: A Retrospective Study.

Objective: To investigate the correlation between background factors and blood pressure variability (BPV), and the prognostic value of intra-dialytic BPV metrics for cardiovascular death and all-cause mortality in hemodialysis (HD) patients.

Methods: A retrospective study of 264 hD patients was followed up for 36 months. The intra-dialytic BP during the 3-month period for each patient was used to calculate BPV metrics, including standard deviation (SD), coefficient of variation (CV), average real variability (ARV), blood pressure change (ΔBP), and percent change in blood pressure (ΔBP/pre-BP). The primary outcomes were CVD death and all-cause mortality.

Results: Age, body mass index (BMI), predialysis blood pressure, inter-dialytic weight gain rate (IDWG%), α- blockers, and cholesterol levels were positively correlated with intra-dialytic BPV. Hemoglobin and albumin are negatively associated with intra-dialytic BPV. In Cox regression analysis, SBP-ARV, ΔSBP, and ΔSBP/pre-SBP were independent risk factors for CVD death (HR: 1.087, 95% CI: 1.001-1.181, p = 0.047; HR: 1.072, 95% CI: 1.016-1.131, p = 0.011; HR: 1.107, 95% CI: 1.011-1.211, p = 0.028). SBP-ARV showed the largest AUC of 0.593 (p = 0.022) in predicting all-cause death. SBP-ARV, ΔSBP, and ΔSBP/pre-SBP showed relatively large area (AUC = 0.631, 0.639, and 0.620; p = 0.007, 0.004, and 0.013 respectively) in predicting CVD death.

Conclusion: Age, BMI, IDWG%, predialysis blood pressure, albumin, hemoglobin, α- blockers, and total cholesterol were significantly correlated with intra-dialytic BPV. SBP-ARV, ΔSBP, and ΔSBP/pre-SBP were independent risk factors for CVD mortality, and there were no differences in prognostic value among various BPV metrics.

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来源期刊
International Journal of General Medicine
International Journal of General Medicine Medicine-General Medicine
自引率
0.00%
发文量
1113
审稿时长
16 weeks
期刊介绍: The International Journal of General Medicine is an international, peer-reviewed, open access journal that focuses on general and internal medicine, pathogenesis, epidemiology, diagnosis, monitoring and treatment protocols. The journal is characterized by the rapid reporting of reviews, original research and clinical studies across all disease areas. A key focus of the journal is the elucidation of disease processes and management protocols resulting in improved outcomes for the patient. Patient perspectives such as satisfaction, quality of life, health literacy and communication and their role in developing new healthcare programs and optimizing clinical outcomes are major areas of interest for the journal. As of 1st April 2019, the International Journal of General Medicine will no longer consider meta-analyses for publication.
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